How is peptic ulcer disease treated?
Most ulcers can be healed with medications. Surgery is rarely needed except when complications have developed. This treatment strategy became standard in the late 1970s with the development of the drugs that were capable of reducing the stomach’s ability to produce acid. The initial steps in treating ulcers include the identification of H. pylori infection and/or the use of NSAIDs. NSAIDs should be stopped, if possible. Patients who have H. pylori should be treated for the infection. No single drug effectively cures H. pylori infection, although research is ongoing. As a result, treatment involves taking several medications, usually two antibiotics along with a medication that reduces stomach acid, for 10 days to 2 weeks. These regimens can successfully cure infection in up to 90 percent of people. The most important factor influencing the success of treatment is compliance with the drug regimen. Compliance refers to taking all prescribed medications as directed by the physician’s inst
Treatment for peptic ulcer disease centers around the reduction of hostile factors, and increasing and augmenting protective factors. Specifically, the goal of therapy is to relieve symptoms, heal craters, and prevent recurrences and complications. Medical therapy should include treatment with drugs and an attempt to accomplish the following: 1) eradicate the H. pylori infection, 2) reduce gastric acidity by mechanisms that inhibit or neutralize acid secretion, 3) coat ulcer craters to prevent acid and pepsin from penetrating to the ulcer base, 4) provide a prostaglandin analogue, 5) remove environmental factors such as NSAIDs and smoking, and 6) reduce emotional stress (in a subset of patients). Endoscopic therapy is used to treat complications, such as bleeding, that may arise in particularly recalcitrant ulcers. With the increased success of new acid-reducing and other pH-stabilizing drugs, there has been a decreased need to resort to surgery to treat peptic ulcer disease. The most
